Which medications are used in the treatment of male breast cancer?

Updated: Jun 30, 2016
  • Author: Bagi RP Jana, MD; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

Answer

Recomendations for use of systemic therapy in male breast cancer are generally the same as in female breast cancer, because the rarity of male breast cancer has precluded the performance of clinical studies. Tamoxifen is the recommended adjuvant endocrine therapy. Duration is at least 5 years and in appropriate patients can be extended to 10 years, given the results of the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial. [10]  

No data support the use of aromastase inhibitors in men. In fact, a retrospective study indicates that aromatase inhibitors may be associated with poorer outcomes when compared with tamoxifen. [11]  Use of adjuvant chemotherapy mirrors the use in women with breast cancer.

Most cases of metastatic male breast cancer are estrogen receptor (ER)–positive, and guidelines from the European School of Oncology and the European Society of Medical Oncology recommend endocrine treatment with tamoxifen as the preferred option for these patients, unless they have suspected or proven endocrine resistance or rapidly progressive disease that requires a fast response. [12]  Second-line hormonal approaches include orchiectomy, aromatase inhibitors, and androgen ablation. [13] However, chemotherapy can also provide palliation.


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